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What is Krokodil (desomorphine)? Effects, Symptoms, and Treatment

Krokodil addiction represents one of the most severe and destructive forms of drug abuse, primarily affecting parts of Eastern Europe and Russia. Krokodil, sometimes spelled Crocodil is slang for the drug desomorphine, which gained notoriety for its horrifying effects, including flesh-eating symptoms. Originating in Russia in the early 2000s as a cheaper alternative to heroin, the drug is synthesized using codeine and toxic household ingredients like gasoline, iodine, and hydrochloric acid.

The effects of krokodil are devastating, both physically and mentally. It produces a high similar to heroin but is far more potent and dangerous. The drug’s potency is coupled with a significantly shorter high, often compelling users to take frequent doses, which exacerbates its harmful effects.

Krokodil’s most notorious and chilling symptom is its flesh-eating effect. Users often develop severe tissue damage, infections, and gangrene at the injection sites. This gruesome side effect is primarily due to the toxic and corrosive substances used in the drug’s homemade synthesis, which cause severe damage to the skin, muscle, and bone.

Understanding the origin, effects, and symptoms of krokodil addiction is crucial for public health awareness and interventions. The drug’s rapid physical deterioration of users underscores the urgent need for effective addiction treatment and prevention strategies.

What is Krokodil?

Desomorphine, commonly known by its street names “Krokodil” or “Crocodil,” is a synthetic opioid first synthesized in the 1930s in the United States. Although it has no accepted medical use in the U.S. and has been a controlled substance since 1936, desomorphine gained notoriety due to its severe and harmful effects when abused.

Krokodil, or Desomorphine, is a semi-synthetic opioid from Russia, made from codeine and toxic substances like gasoline or hydrochloric acid. Named after the Russian word for crocodile, it refers to the scaly skin at injection sites.

Krokodil is an analog of morphine but is estimated to be 8-10 times more potent. Krokodil addicts continue to use the drug despite the severe consequences that come with use such as severe skin conditions, tissue death, and gangrene all of which make users look like they are decaying. This destructive effect is largely because the drug is often homemade, using over-the-counter ingredients like codeine mixed with other substances such as iodine, gasoline, paint thinner, hydrochloric acid, or red phosphorus.

What Are The Signs, Symptoms, and Effects Of Krokodil?

Effects Of Injecting Krokodil Desomorphine Infographic

Krokodil, a street name for desomorphine, leads to a host of severe health issues with potentially fatal outcomes. According to research by Alves EA, Grund JP, Afonso CM, Netto AD, Carvalho F, Dinis-Oliveira RJ in 2015 on the harmful chemistry behind krokodil synthesis, individuals who use krokodil may experience acute and chronic symptoms, including:

  • Severe Skin and Soft Tissue Injuries: Users often develop thrombophlebitis, severe ulcerations, gangrene, and necrosis, which may rapidly progress to require limb amputation.
  • Systemic Infections: Frequent complications include pneumonia, sepsis, meningitis, and osteomyelitis, contributing to significant morbidity.
  • Neurological Impairments: Chronic use can lead to motor skill degradation and memory issues, impacting daily functioning and quality of life.
  • Organ Damage: Liver and kidney functions are often compromised, which can exacerbate other health issues.
  • Psychological Effects: Mental health deteriorates, marked by a decline in cognitive functions and psychological stability.
  • Mortality: The potent toxicity of the drug can quickly lead to death if left untreated.

These signs and effects highlight the extreme danger associated with krokodil use, underlining the urgent need for intervention and treatment to prevent grave health consequences. This substance is known for causing serious health issues, including severe skin ulcerations and infections, leading to gangrene and frequent limb amputations. The hazardous production process, often involving toxic substances, contributes to these severe health effects, making desomorphine a particularly dangerous street drug.

What Is The “Flesh-Eating” Aspect Of Krokodil?

Korkodil Flesh Eating Drug Explanation Infographic

One of the most horrifying effects of Krokodil is its impact on the skin and flesh. In extreme cases, the bones and tendons become visible as the flesh deteriorates, earning the drug its “flesh-eating” moniker since it commonly results in limb amputation. The drug is highly corrosive, causing tissue necrosis that leads to gangrene and open sores as a result of the contaminants that occur as a result of using over-the-counter ingredients like codeine mixed with other substances such as iodine, gasoline, paint thinner, hydrochloric acid, or red phosphorus according to Jeanna Marraffa, clinical toxicologist in the Upstate New York Poison Center, who spoke about the dangers of opioid contaminants on the 2013 Upstate Medical University Informed Patient Podcast.

Who uses Kokodil?

Desomorphine is primarily abused for its potent opioid-like effects. Initially reported internationally in 2002, the abuse of desomorphine has been particularly noted among young adults in Russia by 2009, as a cheaper alternative to heroin according to Drug Enforcement Administration (DEA), Diversion Control, Division, 2019 Drug & Chemical Evaluation Section on Desomorphine. The typical user often seeks the intense high it provides, despite the severe physical consequences. Users commonly synthesize the drug illicitly from codeine and predominantly administer it intravenously.

The illicit use and distribution of desomorphine highlight significant public health concerns due to its high addiction potential and the rapid development of physical dependence among its users.

Can Krokodil Addiction Be Treated?

Krokodil addiction can be treated, but it requires immediate and comprehensive medical and psychological care. Krokodil is an opioid but because of the extra chemicals that it is created with, the detox symptoms are severe and sometimes fatal without the right care and also depend on how far the physical harm to the body has progressed. Treatment for Opioid addiction involves detoxification, medication-assisted treatment to manage withdrawal symptoms, and long-term rehabilitation programs. Psychological support and therapy are crucial due to the severe physical and mental health issues associated with krokodil use.

Where to get Treatment for Opioid Abuse

If you or someone you care about is struggling with opioid addiction, there is effective addiction help available in New Jersey. At our Drug and alcohol rehab in New Jersey, we use personalized, evidence-based care to help people get on the road to recovery.

Contact our knowledgeable and compassionate admissions team to learn more about the types of addiction treatment offered. The admissions team is on hand 24/7 to provide more information about treatment options, ways to pay for rehab, and insurance plans covering treatment. They can also guide you through the rehab admissions process.

Recovery is possible and we’re here to help.

What Is The Difference Between Krokodil and Tranq?

Tranq and Krokodil, though chemically distinct, both induce similar harmful effects like necrotic lesions, and deteriorating skin and muscle. Krokodil is a mix of prescription drugs and household items, and Tranq, or Xylazine, depresses the central nervous system, causing sedation.

Tranq Vs Krokodil Flesh Eating Drugs

According to authoritative sources like the DEA and CDC, Xylazine has been linked to severe skin conditions, including ulcers and necrosis, which is the medical term for tissue rot. These adverse effects can escalate to the point where amputation becomes necessary. Both drugs are extremely potent with Krokodil estimated to be 8-10 times stronger than morphine, surpassing even heroin and fentanyl. The California Poison Control lists a range of severe side effects for Krokodil, including but not limited to pneumonia, sepsis, meningitis, and osteonecrosis. Xylazine or Tranq is responsible for the climbing opiate overdose rate with one study from 10 US cities showing xylazine was involved in less than 1% of drug overdose deaths in 2015 and in nearly 7% in 2020 (Friedman J, Montero F, Bourgois P, et al. Drug and alcohol dependence. 2022).

While both drugs can cause severe skin deterioration, Krokodil’s effects are generally more extreme. Drugs.com notes that Krokodil frequently leads to severe vein damage, soft tissue infections, necrosis, and gangrene. In contrast, Xylazine (tranq) is a sedative drug with a severe impact when mixed with other drugs that is less catastrophic when it comes to skin conditions.

Both drugs pose significant risks, including:

  • Localized injuries
  • Neurological impairments such as motor and memory issues
  • Liver and renal impairment
  • Death

Why is Krokodil So Dangerous?

The extreme danger of Krokodil lies in its impurities and corrosive ingredients. Unlike pharmaceutical-grade opioids, Krokodil is often produced in makeshift labs, leading to a high concentration of toxic substances. These impurities exacerbate the drug’s already severe health risks.

What Are the Immediate Health Risks of Using Krokodil?

The immediate health risks of using krokodil include severe skin ulcers, infections, gangrene, and damage to veins and soft tissue. Users also face a high risk of overdose, which can lead to respiratory depression, coma, and death. The toxic ingredients in krokodil can also cause damage to internal organs, including the brain, liver, and kidneys.


Why Do People Use Krokodil Despite Its Dangers?

People may use krokodil due to its low cost and high potency, especially in regions where heroin is expensive or difficult to obtain. The rapid and intense high it provides can also be a factor. However, lack of awareness about its severe side effects plays a significant role in its use.


What Are the Long-Term Effects of Krokodil Use?

The long-term effects of krokodil use include chronic skin infections, irreversible limb damage requiring amputation, severe scarring, and damage to internal organs. Long-term users may also suffer from neurological impairments, including memory loss, impaired concentration, and motor skill difficulties.


How Can Communities Prevent the Spread of Krokodil Addiction?

Communities can prevent the spread of krokodil addiction by increasing awareness of its dangers, providing support and resources for addiction treatment, and implementing harm reduction strategies. Education programs and access to safe, effective treatment options for opioid addiction are also crucial.

What Is the Legal Status Of Krokodil?

Due to its extreme health risks, Krokodil is illegal in most countries. However, its low production cost and high potency make it an attractive option for those who can’t afford or access other opioids, perpetuating a cycle of abuse and devastation.

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